Nursing Elites

1. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

2. A client with diabetes is being taught by a nurse about the dietary source that should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching?

• A. "Most of my calories each day should be from fats."?
• B. "I should eat more calories from complex carbohydrates than anything else."?
• C. "Simple sugars are needed more than other calorie sources."?
• D. "Protein should be my main source of calories."?

Correct answer: B

Rationale: The correct answer is '"I should eat more calories from complex carbohydrates than anything else."?' Clients with diabetes should focus on complex carbohydrates as their primary calorie source because they have a lower impact on blood sugar levels compared to simple sugars or fats. Choice A is incorrect because a high intake of fats can lead to various health issues. Choice C is incorrect because simple sugars can cause rapid spikes in blood sugar levels. Choice D is incorrect as while protein is important, it should not be the main source of calories for someone with diabetes.

3. Gina, A client in prolong labor said she cannot go on anymore. The health care team decided that both the child and the mother cannot anymore endure the process. The baby is premature and has a little chance of surviving. Caesarian section is not possible because Gina already lost enough blood during labor and additional losses would tend to be fatal. The husband decided that Gina should survive and gave his consent to terminate the fetus. The principle that will be used by the health care team is:

• A. Beneficence
• B. Non malfeasance
• C. Justice
• D. Double effect

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

5. Why are LDLs known as the 'bad' type of cholesterol?

• A. LDL (Low-Density Lipoprotein) is considered 'bad' cholesterol because it deposits cholesterol on the walls of arteries, leading to plaque formation and narrowing of the arteries (atherosclerosis).
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: LDL (Low-Density Lipoprotein) is known as the 'bad' type of cholesterol because it deposits cholesterol on the walls of arteries, leading to plaque formation and narrowing of the arteries (atherosclerosis). This narrowing can restrict blood flow and increase the risk of serious cardiovascular conditions. The statement and the reason are directly related because the adherence of LDL to arterial walls and the subsequent narrowing of the lumen are the primary reasons why it is considered detrimental to heart health. Choice B is incorrect because the statement and reason are related. Choice C is incorrect because both the statement and the reason are correct. Choice D is incorrect because the statement correctly identifies LDL as the 'bad' type of cholesterol due to its actions in the arteries.

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